| NPI | 1275920852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 6397-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 165043-30) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2021-01-11 |